Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207818
Report Date: 08/26/2019
Date Signed: 08/26/2019 10:22:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:BRAGG FAMILY CHILD CAREFACILITY NUMBER:
426207818
ADMINISTRATOR:GABRIELA BRAGGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 346-6402
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 7DATE:
08/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Gabriela BraggTIME COMPLETED:
02:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced annual/random and met with Licensee Ms. Gabriella Bragg and assistant. There were 7 children present. The home was toured inside and out. There are 3 bedrooms and 2 baths. The garage was converted to day care room. LPA observed age appropriate toys, play structure and equipment. The backyard is not accessible to day care children. The nearby park is used for outdoor games and activities. One bedroom is used by older children for napping. Licensee stated there are no guns nor ammunition in the home. There were no bodies of water observed. Hazardous items, detergent and cleaning compounds are inaccessible to children in care.

CPR and First Aid expires on 2/23/21. Fire extinguisher was serviced on 01/09/19. Licensee and assistant have met the SB 792, immunization record is on file. Smoke detector and carbon monoxide detector were present and functional. AB 1207 Mandated Reporter Training was taken on 7/27/2018. Home conducts fire and disaster drill, last drill was conducted on 7/25/2019. Home has current children's roster. Children's files were reviewed. LPA observed licensee did not update and maintain the immunization record
(PM 286 B) of Child #s 1,2, 3, 4 5, & 6. All licensing required forms are posted by the entrance. LPA discussed the Safe Sleep Concept and provided flyers to licensee. Effects of Lead Exposure was also discussed.

Continued on 809 C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: BRAGG FAMILY CHILD CARE
FACILITY NUMBER: 426207818
VISIT DATE: 08/26/2019
NARRATIVE
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Home is not providing Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

In the areas evaluated deficiency was cited under Title 22 Division 12. (809 D) Appeal Rights Given.



Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

LPAs observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: BRAGG FAMILY CHILD CARE
FACILITY NUMBER: 426207818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/05/2019
Section Cited

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(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.
(1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.
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This requirement is not met as evidenced by:
Based on LPA's review of childrens file, licensee failed to maintain and update the immunization records Child #s 1 to 6 failed (form PM 286.) This poses a potential risk to health and safety of children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 08/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/26/2019
LIC809 (FAS) - (06/04)
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